Hindawi

International Journal of Vascular Medicine

Volume 2017, Article ID 6061306, 5 pages
https://doi.org/10.1155/2017/6061306

Research Article
Dyslipidemia in Patients with a Cardiovascular Risk and Disease
at the University Teaching Hospital of Yaoundé, Cameroon

Vicky Jocelyne Ama Moor,1 Sylvie Ndongo Amougou,2 Sebastien Ombotto,3

Felicien Ntone,2 Doriane Edna Wouamba,3 and Bernadette Ngo Nonga4
1
Department of Biochemistry, Faculty of Medicine and Biomedical Sciences, University of Yaoundé I, Yaoundé, Cameroon
2
Department of Internal Medicine, Faculty of Medicine and Biomedical Sciences, University of Yaoundé I, Yaoundé, Cameroon
3
Institute of Medical Technology, Yaoundé, Cameroon
4
Department of Surgery, Faculty of Medicine and Biomedical Sciences, University of Yaoundé I, Yaoundé, Cameroon

Correspondence should be addressed to Bernadette Ngo Nonga; ngonongab@yahoo.com

Received 1 June 2016; Revised 4 October 2016; Accepted 15 December 2016; Published 9 January 2017

Academic Editor: Thomas Schmitz-Rixen

Copyright © 2017 Vicky Jocelyne Ama Moor et al. This is an open access article distributed under the Creative Commons
Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is
properly cited.

Objective. To determine the frequency of lipid abnormalities in patients with a cardiovascular risk and disease at the University
Teaching Hospital (UTH) of Yaoundé. Materials and Methods. We conducted a cross-sectional study from 1 March to 31 May 2015
at the UTH of Yaoundé. We included all patients seen in the outpatient department with a diagnosis of a cardiovascular disease or a
risk factor for cardiovascular disease. Patients who accepted to participate in the study were asked to answer a questionnaire; after
that a blood sample was taken for lipid profile. An informed consent was signed by all the participants and the study has received
approval from the national ethic committee. Results. We recruited 264 patients of which 119 were men and 145 were women with a
sex ratio of 0.82. Mean age was 61.36 years. The frequency of lipid profiles abnormalities was as follows: low HDL cholesterol
(44.3%), hypertriglyceridemia (18.9%), high LDL cholesterol (3.8%), and high total cholesterol 3.4%). Hypertriglyceridemia was
strongly associated with type 2 diabetes mellitus. Conclusion. Low levels of HDL cholesterol and hypertriglyceridemia are more
prevalent in our study population. More studies are needed to confirm this finding in our environment.

1. Introduction due to elevation of both cholesterol and triglycerides [3].

Cardiovascular diseases involve the cardiovascular system:
heart, blood vessels, and the circulatory system [1]. They
represent the first cause of invalidity in developed countries.
According to World Health Organization, the prevalence of
cardiovascular diseases will double by 2020 and will rank
before the HIV/AIDS infection [2].
One of the major risk factors of cardiovascular dis-
eases is arteriosclerosis which is secondary to the excess of
LDL cholesterol. Clinical manifestations of arteriosclerosis
are found in coronary artery disease, ischemic stroke, and
peripheral vascular occlusive diseases. Dyslipidemia is a
metabolic abnormality leading to a persistent increase in
the plasmatic concentration of cholesterol and triglycerides.
There are currently three types of dyslipidemia, hypercholes-
terolemia, hypertriglyceridemia, and mixed hyperlipidemia,
Dyslipidemia is a common cause of morbidity all over the
world, and the most common form is hypercholesterolemia
defined as a total cholesterol level above 5,0 mmol/L or
190 mg/L. One-third of ischemic heart diseases in the world
are secondary to hypercholesterolemia, and it is estimated
that hypercholesterolemia is responsible for 2.6 million
(4,5%) deaths in the world [4]. In 2008, the worldwide
prevalence of hypercholesterolemia in western countries was
39% in males and 40% in females [5]. In Cameroon, very few
studies have been conducted to determine the frequency of
the dyslipidemias in our environment.
The objective of this study was to determine the preva-
lence of lipid profile abnormalities in patients presenting
with a cardiovascular disease or risk factor at the University
Teaching Hospital of Yaoundé, Cameroon.
International
2 Journal of Vascular Medicine International Journal of Vascular Medicine2

2. Patients and Methods Table 1: Lipid profile abnormalities in the studied population.

2.1. Patients. We carried out a cross-sectional study from Parameters Values (g/L) Number Percentage
March to May 2015 at the University Teaching Hospital Low ≤ 1.4 42 15.90%

(UTH) of Yaoundé. The study included all patients with a Total cholesterol Normal 1.5–2.7 213 80.70%

cardiovascular disease seen at the UTH during that period: High > 2.7 9 3.40%
ischemic heart disease, stroke, peripheral vascular dis- Low ≤ 0.41 117 44.30%
ease, hypertension, and cardiomyopathies; we also included HDL cholesterol Normal 0.41–0.75 131 49.60%
patients with a risk factor for cardiovascular disease such
High > 0.75 16 6.10%
as diabetes mellitus. All patients were informed about the
protocol and if they accepted to participate in the study, they Low ≤ 1 100 37.90%
were asked to sign a consent before enrollment. We excluded LDL cholesterol Normal 1–1.9 154 58.30%
patients with an incomplete file and hemolyzed blood serum High > 1.9 10 3.80%
and those who refused to participate in the study. Low < 1 123 46.60%
Triglycerides Normal 1–1.5 91 34.50%

2.2. Methods. Patients were given a questionnaire adminis-
tered by the investigators. The questionnaire was first admin-
istered to 16 nonmedical persons accompanying patients
at the emergency department as a pretest and validated.
Collected data were sociodemographic information (age and
sex,) and cardiovascular risk factors and diseases. Blood was
drawn by the same person who respected the appropriate
recommendations before the determination of plasma lipid’s
abnormalities.
The first phase was the preanalytical phase: patients were
asked to fast for 12 hours before blood was drawn. The
elbow was cleaned and blood was taken in a tube without
anticoagulant; we use a loose vein occlusion to minimize the
risk of hemolysis. Specimens were taken to the laboratory in
less than 20 minutes after the procedure in a specific box.
The tubes were centrifuged at 3000 rpm for 5 minutes
before preservation.
Our judgment criteria for a dyslipidemia were as follows
High > 1.5 50 18.90%
Total 264 100.00%
3. Results
3.1. Sociodemographic Characteristics of the Patients. During
that period, 596 patients with a cardiovascular disease or risk
factors were seen at the UTH, of which 350 met the inclusion
criteria and accepted to participate in the study. Because of
poverty, only 264 were able to have a lipid profile done and
86 patients were then excluded because of incomplete file. The
population of the study composed of 264 patients of which 119
(45.1%) were men and 145 (54.9%) were women, giving a sex
ratio of 0.81. The mean age was 61.36 years with a minimum
of 32 years and a maximum of 88 years. The most common
age group was between 50 and 60 years and represented 36%
of patients.

[6]:
Total cholesterol > 2,70 g/L
HDL cholesterol < 0,44 g/L
LDL cholesterol > 1,88 g/L
Triglycerides > 1,50 g/L
Analysis was done using the CYAN START photometer of
the CYPRESS Laboratory (Langdorp, Belgium). Total choles-
terol, HDL cholesterol, and triglycerides were determined
using an enzymatic method found in commercial kits of the
CYPRESS Laboratory (Langdorp, Belgium); LDL cholesterol
was calculated using the formula of Friedewald (1972) [7].
Results were validated using a quantitative control serum.
3.2. Risk Factors for Cardiovascular Disease and Life Style.
Sedentariness was found in 188 (71%) patients, 142 (53.7%)
patients drank alcohol regularly, obesity was found in 74
(27.9%) patients, 19 (7.1%) patients were smokers, hyperten-
sion was found in 169 (64%) patients, and 43 (16.3%) patients
had diabetes mellitus. The association of hypertension and
diabetes mellitus was found in 29 patients (10.98%).
2.4. Ethical Considerations. The study has obtained ethical
clearance from the national ethic committee of Cameroon
(number CEI-UD/246/02/2015/T). Informed consent was
obtained before enrollment in the study.

2.3. Statistical Analysis. Data were encoded using the CS

Pro software version 4.1. Statistical analysis was done using
Epi Info 3.54 software and represented in tables using the
Microsoft Excel 2010 software. Statistical test used was chi
square. Difference was found to be significant if 𝑃 < 0.05.
 International
3 Journal of Vascular Medicine International Journal of Vascular Medicine3

3.3. Cardiovascular Pathologies. The most common cardio-

vascular disease was hypertension found in 169 patients
(64%), followed by stroke found in 35 patients (13,25%),
ischemic heart diseases in 14 patients (5.3%), and other
cardiomyopathies in 16 patients (6.06%). One patient had
deep venous thrombosis.

3.4. Abnormalities of the Lipid Profile. The results of the lipid

profile in the 264 patients are shown in Table 1: only 9 patients
(3.4%) had high total cholesterol levels, 10 (3.8%) patients
had a higher than normal LDL cholesterol, and 50 (18.9%)
had above normal triglycerides levels, giving prevalence of
dyslipidemia of 26%.
Mean total cholesterol levels and LDL cholesterol levels
were higher in women than in men and this difference was
significant (𝑃 = 0.01 and 𝑃 = 0.03, resp.) (Table 1), while
mean HDL cholesterol and triglycerides were also higher in
International
4 Journal of Vascular Medicine International Journal of Vascular Medicine4

Table 2: Comparison of the lipid profile in men and women.

Lipid Sex Mean levels Lowest Maximum Standard deviation 𝑃 value

Male 1.78 g/L 0.69 g/L 2.99 g/L 0.43
Total cholesterol 𝑃 = 0.01
Female 1.90 g/L 0.93 g/L 3.37 g/L 0.44
Male 0.46 g/L 0.14 g/L 1.26 g/L 0.18
HDL cholesterol 𝑃 = 0.14
Female 0.49 g/L 0.13 g/L 1.22 g/L 0.19
Male 1.09 g/L 0.11 g/L 2.4 g/L 0.42
LDL cholesterol 𝑃 = 0.03
Female 1.18 g/L 0.2 g/L 2.55 g/L 0.39
Male 1.13 g/L 0.40 g/L 3.05 g/L 0.52
Triglycerides 𝑃 = 0.7
Female 1.15 g/L 0.31 g/L 4.33 g/L 0.55

Table 3: Distribution of dyslipidemia in patients with a low HDL as a dyslipidemia, 149 of the patients were having a lipid
cholesterol. abnormality, giving corrected prevalence of 56.4% for a
Low HDL cholesterol
dyslipidemia in our study. Only one patient had high LDL
cholesterol and low HDL and he was considered to have
Triglycerides
high risk lipid profile. In this group, 4 patients (3.4%) had
LDL Low Normal High Total atherogenic dyslipidemia (low HDL and elevated LDL or
Low 14 (11.97%) 12 (10.26%) 11 (9.4%) 37 (31.62%) triglycerides) (Table 3).
Normal 28 (23.93%) 26 (22.22%) 22 (18.8%) 76 (64.96%) From 131 (49.6%) patients who had a normal HDL
High 1 (0.85%) 2 (1.71%) 1 (0.85%) 4 (3.42%) cholesterol, 32 (24.4%) had also low LDL and triglycerides
Total 43 40 34 117 level, 27 (20.61%) had normal LDL and TG levels, 6 (4.58%)
had a normal HDL and an elevated LDL, and 15 (11.45%) had
elevated triglycerides. There was no mixed dyslipidemia in
Table 4: Distribution of dyslipidemia in patients with a normal level this study (Table 4).
of HDL cholesterol. Sixteen (6%) patients had a high HDL cholesterol, of
Normal HDL cholesterol which 6 (37.5%) had an elevated LDL and a low triglyceride
Triglycerides level, 2 (12.5%) had normal LDL and triglycerides, and one
LDL Low Normal High Total
had elevated triglycerides with a low LDL and high HDL
(Table 5).
Low 32 (24.43%) 14 (10.69%) 7 (5.34%) 53 (40.46%)
Regarding atherogenic index (total cholesterol/HDL
Normal 37 (28.24%) 27 (20.61%) 8 (6.11%) 72 (54.96%) cholesterol), 95 (36%) of our patients had an index of more
High 1 (0.76%) 5 (3.82%) 0 (0%) 6 (4.58%) than 4.5 and 169 (64%) had an index below 4.5.
Total 70 46 15 131 There was a strong association between diabetes mellitus
and hypertriglyceridemia (odds ratio = 2.73 and 𝑃 = 0.003).
Table 5: Distribution of dyslipidemia in patients with a high HDL
Low HDL cholesterol level and hypertriglyceridemia
cholesterol. were more frequent in patients with hypertension (74.4% and
84%, resp.). It was the same in patients with diabetes mellitus
High HDL cholesterol (11.1% and 18%).
Triglycerides
LDL Low Normal High Total
Low 6 (37.5%) 3 (18.75%) 1 (6.25%) 10 4. Discussion
Normal (%) 4 (25%) 2 (12.5%) 0 (0%) 6 (37.5%) Considering low HDL cholesterol or hypocholesterolemia
Total 10 5 1 16 HDL as a risk factor we have found prevalence of dyslipi-
demia in our patients with a cardiovascular risk or disease
of 56.4%, with 36% of the patients having an elevated
women than in men, but this difference was not statistically atherogenic index of more than 4.5. Dyslipidemia would then
significant (Table 2). Based on the definition of dyslipidemia, be the fourth risk factor for cardiovascular disease as reported
the most common abnormality was hypertriglyceridemia by Karaye et al. in Nigeria [8].
(18.90%) followed by LDL hypercholesterolemia (3.8%) and Levels of total, HDL, and LDL cholesterol and TG were
total hypercholesterolemia (3.4%). Low level of HDL choles- more elevated in women than in men, although our values
terol was found in 117 (44.3%) patients (Table 3): 35 patients were lower than the ones reported by Youmbissi et al. in
were on statin medications (anticholesterol drugs); the 2001 [9]. This difference may be due to the difference in the
remaining 82 patients were not on any anticholesterol drugs. number of patients (we have a larger number of patients) and
Low HDL and low LDL cholesterol were simultaneously also Youmbissi et al. studied only patients with hypertension.
present in 37 (31.62%) patients from 117 who had low HDL Thirty-five of the patients were on anticholesterol medica-
cholesterol (Table 3). These patients were considered to have tions which may have contributed to the increase of the
low risk lipid profile. If we consider low HDL cholesterol
International
5 Journal of Vascular Medicine
number of patients with low HDL cholesterol and low LDL
cholesterol at the same time. High levels of abnormal lipid
profile in women compared to men have also been reported in
Nigeria [10]. Mean triglycerides levels in our study were lower
than the ones reported from Gabon [11] and mean values
of HDL cholesterol were lower than the ones reported by
Youmbissi et al. from Cameroon [9].
The most common lipid abnormality was low HDL
cholesterol, followed by elevated triglycerides and elevated
LDL cholesterol, with high level of total cholesterol being
the last one. All these values were more elevated in women
than in men. This result is different from the one reported by
Apetse et al. from Togo who found total hypercholesterolemia
followed by LDL hypercholesterolemia and the hypertriglyc-
eridemia to be the most common lipid abnormalities in
patients with stroke [12]. A study in urban New Delhi has
shown prevalence of low HDL-C of 37% in the studied
population, which was very close to our findings of 44%, as
reported by Chandra et al. [13].
In our study, in patients with hypertension, hypocholes-
terolemia HDL was the most common lipid abnormality
unlike Youmbissi et al. who have found that hypercholes-
terolemia was the most common abnormality followed by
hypertriglyceridemia and mixed hyperlipidemia [9]. Tiahou
et al. from Ivory Coast found also hypercholesterolemia as
the most common lipid abnormality [14] but they carried out
a study in all patients who have done a lipid profile at the
University Hospital of Cocody during that period and did not
consider low HDL cholesterol as an abnormality.
The prevalence of total hypercholesterolemia was 3.4% of
patients, which is lower than the one reported by Ndiaye et
al. from Senegal (52.34%) in patients with an ischemic stroke;
this prevalence is also lower than the one reported by Maiga
from Mali in patients with hypertension (23,26%) and the one
reported by Goudote from Senegal in patients with coronary
artery diseases (19,6%) [15–17]. Hypercholesterolemia is the
most common abnormality in patients from Senegal and
Ivory Coast [2, 14].
Hypercholesterolemia LDL was found only in 3.8% of
our patients; this is very low compared to the percentage
found by Apetse et al. in patients with a stroke which was
47,96% in Togo [12] and it is also low compared to the
one found by Doupa et al. which was 22,5% in Senegal [2].
We have reported this finding in a previous study, where
we have found that hypercholesterolemia was uncommon
in patients with ischemic stroke in association with low
prevalence of significant carotid stenosis [18]. Rather than
hypercholesterolemia in high risk patients, we have found
hypocholesterolemia HDL to be very high in our study
population and this was the most common abnormality
found in 44.3% of the patients. Hypocholesterolemia HDL
has been also found to be common in Nigeria in a group
of patients with cardiovascular risks as reported by Umar
et al. [19]. Gonzalez-Pacheco et al. have also reported a
high percentage of patients with hypocholesterolemia HDL
(68.6%) in patients with acute coronary syndrome in Mexico
[20]. The low level of HDL cholesterol may be due to antilipid
medication (only 35 patients were taking anticholesterol
medication); we believe that this low HDL cholesterol is
International Journal of Vascular Medicine5
a common finding in the lipid profiles of patients in our
environment. Low levels of HDL cholesterol are as common
as high levels of LDL cholesterol as has been reported in
one study in which low level of HDL was the most common
abnormality of lipid profile found in the population [21];
although low HDL-C is considered as a dyslipidemia and
elevated HDL-C has been found to have cardiovascular
protective effect, little is known about the exact clinical
relevance of low HDL-C [22].
In general, low levels of HDL cholesterol in human are
secondary to type 2 diabetes mellitus and the metabolic syn-
drome because of the increase catabolism due to hypertriglyc-
eridemia [21]. There are other reported causes of low level
of HDL: sedentariness, low fat diet, medications, and drugs;
genetic abnormalities are less common [21]. In one study, low
HDL cholesterol in association with hypertriglyceridemia has
been found in 8% of the patients [23]. The atherogenic index
is high when the HDL is low; 36% of our patients had an
elevated atherogenic index and 44.3% had a very low HDL
level, making us state that low HDL should also be considered
as a risk factor for cardiovascular disease in Cameroon as
reported [24, 25]. Elevated LDL which is a well-known risk
factor is low in our country, while low HDL which is equally
a recognized factor is more prevalent.
Hypertriglyceridemia was present in 18.9% of our patients
which is more than the prevalence found by Nissaf et al. in
Tunisia which was 13.6% [23] and this was lower than the
25% found by Sumner et al. in their patients with a metabolic
syndrome [26].
There was a strong association between diabetes and
hypertriglyceridemia as has been found by Lokrou in Ivory
Coast [27]. There was no association between tobacco and
hypertriglyceridemia or alcohol and hypertriglyceridemia as
has been reported by Abessolo et al. in Gabon [28].
5. Conclusion
In this population with cardiovascular risk factors and dis-
eases, the most common lipid abnormality was low HDL
cholesterol. Few patients presented elevated LDL cholesterol
compared to the literature, making hypercholesterolemia be
considered as a less common cardiovascular risk factor com-
pared to hypertension and low HDL cholesterol which were
very common. We would recommend multicenter studies
and population based studies to further assess this important
finding.
Competing Interests
The authors declare that there are no competing interests
regarding the publication of this paper.
Authors’ Contributions
Bernadette Ngo Nonga, Vicky Jocelyne Ama Moor, and
Sylvie Ndongo Amougou contributed to the design of the
study. Doriane Edna Wouamba and Vicky Jocelyne Ama
Moor contributed to the realization of the study. Bernadette
International
6 Journal of Vascular Medicine
Ngo Nonga and Doriane Edna Wouamba contributed to
data analysis. Bernadette Ngo Nonga, Felicien Ntone, and
Sebastien Ombotto contributed to the supervision of the
study.
References
[1] Fondation des Maladies du Coeur du Québec, Statistiques, 2010.
[2] D. Doupa, S. M. Seck, C. A. Dia et al., “Dyslipidemia, obesity
and other cardiovascular risk factors in the adult population
in Senegal,” Pan African Medical Journal, vol. 19, article no. 181,
2014.
[3] AFSSAP (Agence Française de Sécurité Sanitaire des Produits
de Santé), “Prise en charge thérapeutique du patient dys-
lipidémique,” Argumentaire, pp. 3–5, 2005.
[4] OMS, Cadre Global Mondial de Suivi, Comprenant des Indica-
teurs, et Série de Cibles Mondiales Volontaires Pour la Lutte Con-
tre les Maladies non Transmissibles, OMS, Geneva, Switzerland,
2012.
[5] OMS, Rapport sur la Situation Mondiale des Maladies non
Transmissibles (Résumé d’Orientation) 2010, OMS, Geneva,
Switzerland, 2011.
[6] T. J. Youmbissi, S. Djoumessi, J. Simo Moyo, C. NouedouI,
C. Tchemy, and E. C. Zam Ngono, “Profil lipidique général
d’un groupe de malades insuffisants rénaux chroniques camer-
ounais,” Médecine d’Afrique Noire, vol. 41, no. 1, 1994.
[7] W. T. Friedewald, R. I. Levy, and D. S. Fredrickson, “Estimation
of concentration of low density lipoprotein cholesterol in
plasma without use of ultracentrifuge,” Clinical Chemistry, vol.
18, pp. 499–502, 1972.
[8] K. M. Karaye, I. Nashabaru, G. M. Fika et al., “Prevalence of
traditional cardiovascular risk factors among Nigerians with
stroke,” Cardiovascular Journal of Africa, vol. 18, no. 5, pp. 290–
294, 2007.
[9] T. J. Youmbissi, S. Djoumessi, C. Nouedoui, P. Ndobo, and
J. Meli, “Profil Lipidique d’un Groupe d’hypertendus Camer-
ounais Noirs Africains,” Médecine d’Afrique Noire, vol. 48, no.
7, pp. 305–314, 2001.
[10] J. O. Idemudia and E. I. Ugwuja, “Plasma lipid profiles in
hypertensive Nigerians,” The Internet Journal of Cardiovascular
Research, vol. 6, no. 2, 2009.
[11] E. Ngou-Milama, A. Liamidi, R. Makandja, M. Methogo,
B. Moundounga, and B. Okomo, “Valeurs de référence du
cholestérol total, des triglycérides, de l’apolipoprotéine A1, de
l’apolipoprotéine B et de la Lp(a) dans la population gabonaise.
Etude sur 1020 sujets,” Bulletin Médical d’Owendo, vol. 18, pp.
60–61, 1997.
[12] K. Apetse, M. Matelbe, K. Assogba et al., “Prévalence de la
dyslipidémie, de l’hyperglycémie et de l’hyperuricémie chez les
patients victimes d’AVC au Togo,” African Journal of Neurologi-
cal Sciences, vol. 30, no. 1, 2012.
[13] K. S. Chandra, M. Bansal, T. Nair et al., “Consensus statement
on management of dyslipidemia in Indian subjects,” Indian
Heart Journal, vol. 66, supplement 3, pp. S1–S51, 2014.
[14] G. Tiahou, K. Deret, A. Monde, M. Agniwo Camara-Cisse, and
Y. Djohan, “Fréquence des bilans lipidiques et prévalence des
dyslipidémies au Laboratoire de biochimie du CHU de Cocody,”
Journal des Sciences Pharmaceutiques et Biologiques, vol. 11, no.
2, pp. 60–65, 2010.
[15] M. Ndiaye, S. M. l. Dadah, L. B. Seck et al., “Profil lipidique
et glucidique des AVCI à la clinique de neurologie du CHNU
International Journal of Vascular Medicine6
de fann,” in Proceedings of the 9ème Congrès International
Francophone de la Société de Pathologie Exotique, UCAD, Dakar,
Senegal, 2013.
[16] A. Maiga, Dépistage des facteurs de risque Cardiovasculaires
(dyslipidemies et Hyperglycemie) au centre de sante de Référence
de la commune V et au CHU Gabriel TOURE (thèse de médecine)
[Ph.D. thesis], Université de Bamako, Faculté De Médecine, De
Pharmacie et D’odontostomatologie, Bamako, Mali, 2009.
[17] P. Y. Goudote, Les infarctus du myocarde thrombolyses: a propos
de 36 cas au service de réanimation de l’hôpital principal de
Dakar [Thèse de Médecine], Faculté De Médecine, De Pharma-
cie Et D’odontostomatologie, Bamako, Mali, 2003.
[18] B. Ngo Nonga, J. C. Mballa, N. Felicien et al., “Prevalence of
significant carotid stenosis and other risk factors in patients
with acute ischemic stroke in Yaounde, Cameroon,” Journal of
Vascular Medicine & Surgery, vol. 4, article 257, 2016.
[19] G. A. Umar, A. G. Okuku, O. C. Oladele, J. J. Aisha Oduh,
and F. J. Abidemi, “Profil lipidique sérique et correlation chez
des patients Nigérians récemment hypertendus,” Vase Manag
Risques Pour la Santé, vol. 9, pp. 763–768, 2013.
[20] H. Gonzalez-Pacheco, M. Vallejo, A. Altamirano-Castillo et al.,
“Prevalence of conventional risk factors and lipid profiles in
patients with acute coronary syndrome and significant coronary
disease,” Therapeutics and Clinical Risk Management, vol. 10, pp.
815–823, 2014.
[21] W. F. Riesen and M. Hug, “HDL bas—haut risque, HDL haut—
faible risque?” Forum Médical Suisse, vol. 8, no. 14, pp. 246–252,
2008.
[22] M. Vergeer, A. G. Holleboom, J. J. P. Kastelein, and J. A. Kuiv-
enhoven, “The HDL hypothesis: does high-density lipoprotein
protect from atherosclerosis?” Journal of Lipid Research, vol. 51,
no. 8, pp. 2058–2073, 2010.
[23] B. A. Nissaf, D. Francis, and B. R. Habiba, “Modèle causal
des cardiopathies ischémiques en Tunisie,” Options Méditer-
ranéennes Série B, no. 41, p. 14, 2002.
[24] M. D. Ashen and R. S. Blumenthal, “Low HDL cholesterol
levels,” The New England Journal of Medicine, vol. 353, no. 12,
pp. 1252–1260, 2005.
[25] C. Besler, T. F. Lüscher, and U. Landmesser, “Molecular mecha-
nisms of vascular effects of high-density lipoprotein: alterations
in cardiovascular disease,” EMBO Molecular Medicine, vol. 4,
no. 4, pp. 251–268, 2012.
[26] A. E. Sumner, J. Zhou, A. Doumatey et al., “Low HDL-
cholesterol with normal triglyceride levels is the most common
lipid pattern in West Africans and African Americans with
metabolic syndrome: implications for cardiovascular disease
prevention,” CVD Prevention and Control, vol. 5, no. 3, pp. 75–
80, 2010.
[27] A. Lokrou, “Hyperlipidemie et Diabète en Côte d’Ivoire: Etude
transversale de 132 cas,” Médecine d’Afrique Noire, vol. 45, no. 10,
p. 123, 1998.
[28] F. Abessolo, S. Bekale, F. Jose, Y. Moutsinga, and E. Milama,
“Profil lipidique, cinétique d’apparition des diènes conjugués et
activité paraoxonase-1 chez le diabétique de type 2 à Libreville
au Gabon,” International Journal of Biological and Chemical
Sciences, vol. 6, no. 2, pp. 572–581, 2012.
 MEDIATORS of

INFLAMMATION

The Scientific Gastroenterology Journal of

World Journal
Hindawi Pub lishing Co rpo rat ion
http:// www.h ind awi.co m
Research and Practice Hindawi Publishing Corporation
Diabetes Research
Hind awi Pub lish ing Co rporation
Disease Markers
Hind awi Pub lish ing Co rporation
http://www.hindawi.com Volume 2014 http :// w ww.h in dawi.co m Volume 2014 Hindawi Publis hing Co rpo ration
Vo lu me 2014 http :// www.h indawi.co m Vo lu me 2014 http://www.h in dawi.com Vo lume 2014

Journal of International Journal of

Immunology Research
Hind awi Pub lish ing Co rporation
Endocrinology
Hind awi Pub lish ing Co rporation
http :// www.h indawi.co m Vo lu me 2014 http :// w ww.h in dawi.co m Volume 2014

Submit your manuscripts at

PPAR Research
Hind awi Pub lish ing Co rporation
http :// w ww.h in dawi.co m
https://www.hindawi.com
BioMed
Research International
Hind awi Pub lish ing Co rporation
Volume 2014 http :// w ww.h in dawi.co m Volume 2014

Journal of
Obesity

Journal of ells Evidence-Based

Ophthalmology Complementary and
Hind awi Pub lish ing Co rporation
http :// www.h indawi.co m Vo lu me 2014

International
Stem C Alternative Medicine
Hind awi Pub lish ing Co rporation
http :// www.h indawi.co m Vo lu me 2014
Journal of
Hind awi Pub lish ing Co rporation
http :// www.h indawi.co m Vo lu me 2014 Hind awi Pub lish ing Co rporation
http :// www.h indawi.co m Vo lu me 2014
Oncology
Hind awi Pub lish ing Co rporation
http :// www.h indawi.co m Vo lu me 2014

Parkinson’s
Disease

Computational and
Mathematical Methods
in Medicine
oural
ogy
AIDS
Research and Treatment
Oxidative Medicine and
Cellular Longevity
Hind awi Pub lish ing Co rporation
http :// www.h indawi.co m Vo lu me 2014

Behavi Vo lu me 201 4
Hind awi Pub lish ing Co rporation
http :// w ww.h in dawi.co m Volume 2014
Hind awi Pub lish ing Co rporation
http :// www.h indawi.co m Vo lu me 2014
Hind awi Pub lish ing Co rporation
http :// w ww.h in dawi.co m Volume 2014

Neurol
Hind awi Pub lish ing Co rporation
http://www.h in da wi.com